I Clicker Questions Test 4

Front 1

Which information obtained by the nurse when admitting a patient with osteoarthritis indicates a need for patient teaching?

Back 1

a. The patient gets information about herbal therapies from a health food store employee.
b. The patient takes glucosamine daily to prevent knee & hip pain.
c. The patient attends a weekly yoga class to improve flexibility & balance.
d. The patient states that prayer helps to improve the knee pain & function.

Hint 1

Correct Answer: A
Rationale: Patients should be informed that employees at health food stores are not educated medical professionals. The other information given by the patient indicates appropriate use of complementary & alternative therapies, & no further teaching is necessary.

Front 2

Complementary & alternative therapies are advocated by many nurses because these therapies

Back 2

a. Promote self-care and self-determination by patients.
b. Are congruent with a view of humans as holistic beings.
c. Are less expensive for patients than conventional therapies.
d. Cause few adverse effects while achieving positive outcomes.

Hint 2

Correct Answer: B
Rationale: CAMs are harmonious with the values of nursing that include a view of humans as holistic beings, an emphasis on healing & partnership relationships with patients, and a focus on health promotion & illness prevention. CAM is not inexpensive, nor is it without adverse or even validated therapeutic effects.

Front 3

When discussing herbal therapy with a patient, the nurse should advise the patient that

Back 3

a. Preparation should be purchased only from reputable manufactures.
b. Herbs rarely cause harm or side effects because they are natural plants.
c. There are no known contraindications or conditions for which herbal therapy cannot be used.
d. Most herbal preparations have been clinically tested for safety and efficacy before marketing

Hint 3

Correct Answer: A
Rationale: Because of a lack of governmental control for clinical testing of herbs or standardization of ingredient concentration or acceptable levels of contamination of pesticides, solvents, bacteria, & heavy metals, the safety & efficacy of herbal preparations are based on the manufacturer’s standards. As such, the reputation & history of the manufacturer must be the major criteria for purchasing herbs. Herbs indeed can be toxic & are contraindicated or should be used with caution in certain persons.

Front 4

Which information obtained by the nurse during the preoperative assessment of a patient is most important to assess further?

Back 4

a. The patient uses several herbal remedies routinely.
b. The patient has used acupressure to relieve postoperative nausea in the past.
c. The patient expresses a wish to use acupuncture for postoperative pain control.
d. The patient recently visited a chiropractor for back pain.

Hint 4

Correct Answer: A
Rationale: Many herbs prolong bleeding time, so further assessment of the types of herbs that are used & how recently they were used is needed before the patient has surgery. The other information given by the patient also requires further assessment but will not affect the timing of the patient’s surgery.

Front 5

Acupuncture is used to

Back 5

a. Relieve pain by causing counter-irritation in another area of the body.
b. Reestablish the flow of Qi through meridians to stimulate the body’s self-healing mechanism.
c. Create an inflammatory response at an acupoint, increasing blood circulation & healing energy.
d. Stimulate the electrical activity of the central nervous system, promoting movement of vital energy through the body.

Hint 5

Correct Answer: B
Rationale: Acupuncture is used to regulate the flow of Qi with the insertion of needles at acupoints, areas where needles may be inserted to unblock obstruction of energy & reestablish the flow of Qi. Counter-irritation and inflammation are not consistent with the theory of Qi, and although electrical stimulation may be applied to the needles in electro-acupuncture, this procedure releases neuropeptides within the CNS.

Front 6

Patients who don’t respond well to ACE inhibitors:

Back 6

African American (unless taken with a diuretic) & Elderly.

Front 7

Angiotensin Receptor Blockers are less effective in this group:

Back 7

African Americans.

Front 8

Which category of drugs works best for African American Patients

Back 8

Calcium Channel Blockers (CCB) lower blood pressure better than drugs in other categories.

Front 9

Why do African American patients typically not respond well to beta blockers?

Back 9

Because they typically have lower renin levels

Front 10

For which patients are Beta Blockers contraindicated?

Back 10

COPD & 2nd & 3rd degree AV block & CHF & Bradycardia.

Front 11

What is an Aneurysm?

Back 11

Outpouching or dilation of an arterial wall, commonly involving the aorta

Front 12

Where are Aneurysm's typically located?

Back 12

Found in abdomen, thoracic aorta, and 3rd is: popliteal

Front 13

What causes Aneurysm's?

Back 13

atherosclerosis

Front 14

superficial thrombophlebitis
In upper extremity. It’s caused by: __________

Back 14

IV

Front 15

superficial thrombophlebitis
In lower extremity. It’s due to: trauma to _________ veins.

Back 15

varicose

Front 16

superficial thrombophlebitis
How do you position extremity?

Back 16

Elevate

Front 17

superficial thrombophlebitis
Do you apply heat or cold?

Back 17

Heat

Front 18

superficial thrombophlebitis
What drugs are used for discomfort?

Back 18

ASA, NSAID, Tylenol

Front 19

superficial thrombophlebitis
If detected, the IV catheter should be removed immediately.
T or F

Back 19

True

Front 20

superficial thrombophlebitis
Should you use anticoagulants?
Should you use compression stockings?

Back 20

Yes, LE after acute thrombophlebitis has passed

Front 21

DVT may have no symptoms or symptoms of unilateral leg edema, pain in leg, warm skin, erythema, temp >100.4 F.

True or False

Back 21

True

Front 22

Is Homan's sign a reliable indicator of DVT?

Back 22

No

Front 23

What is the most serious consequence of DVT?

Back 23

PE and Chronic Insufficiency

Front 24

Easiest and cheapest way to prevent DVT.

Back 24

Early Ambulation

Front 25

In prevention of DVT dorsi flexion and rotation of ankles should occur how often?

Back 25

q 2-4 hours

Front 26

How to treat DVT in hospital:

Back 26

bedrest, elevate limb, and meds, and warm compresses!

Front 27

How long should elastic compression hose be worn post DVT?

Back 27

3 - 6 months